In the future, patients and families will help design and govern the health system. We’re from the future.

@KPSanDiego innovates. Dr. Susan Mahler and Dr. Jeff Benabio with Susan’s daughter Patricia, TEDMED, 2013 (View on

A patient on a governance group for workforce Information technology? Yes!

For some reason, I haven’t posted about the fact that I am part of the National Quality Forum’s (@NatQualityForum) Patient and Family Engagement Action Team. We first got together in February and now it’s August.

I am also part of an effort at Kaiser Permanente to envision the future of health, AND at the same time an exciting part of my job is that I’m the medical partner to the Senior Director of Kaiser Permanente’s Digital Workforce Group, Melina Linder. The Digital Workforce Group exists to help the Kaiser Permanente workforce connect and collaborate, as part of the Digital Services Group, which also produces the world famous

How does all of that come together?

For me, to a place where I envision the (not “a”) health system of the future as being one where patients and families are involved everywhere, from individual treatment experiences, to design, governance and policy.

There’s a great paper that reviews all of this: Carman KL, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff. (Millwood). 2013;32(2):223–31.

We shouldn’t say patients should only be involved in governing parts of the health system that touch them in certain ways. Every part of the health system touches them. I grew up in a health system where member governance is not the exception, it’s the norm (@GroupHealth, you know, the magical health system of the future, in Washington State).

A member (patient) on the Digital Workforce Executive Governance group: Susan Mahler

(Dr.) Susan Mahler is an exceptional person, as exceptional as any one of our 9.5 million members. She has been an educational leader for 35 years, and is now a health system leader in her role as Kaiser Permanente member. Let’s allow video to do the teaching…

As she says, she is also the recipient of a heart transplant, and she is here today because of excellent medical care.

Earlier this year, we asked her to become a member of the Executive Governance group for Kaiser Permanente’s Digital Workforce Group. She said yes!

It’s a journey

I would not be telling the truth if I said, “everyone instantly saw the value of this idea.” I am telling the truth when I say, “everyone said, let’s try it,” because we work in a place where we understand what it means to be there for our members, and…our DNA is a powerful force for good :).

We actually thought about this for awhile – why should a patient helping to govern a group that primarily serves the workforce? Couldn’t she serve purpose better elsewhere? Maybe; however, who does the workforce serve? And as another leader, Gilbert Salinas, BS, MPA told me when I asked him about it (and I will never forget what he said):

Health systems have patient happiness committees and employee happiness committees. They should all be the same committee.

I created this short slide show for my colleagues and also showed it to colleagues on the NQF team, to show the impact of having members involved at the level of governance and more importantly the impact of not having them involved. The story of Mid-Staffordshire in England is beyond sad.

Kaiser Permanente happens to have a Patient and Family Toolkit available to the organization internally. I am working to see if it can be made more widely available, because it covers so many of the basic questions people have about making this happen. Susan herself has been engaged with Kaiser Permanente at multiple levels in the extremely innovative KP San Diego (@KPSanDiego) service area. This includes being part of several unit-based teams, which connect the workforce in solving problems for our members. Voila.

It’s happening + this is the future

So Susan is now with us as part of the team. When we speak of things “Digital Workforce” this includes technologies, tools, and people that enable our workforce to finance and deliver care. There are a lot of acronyms. A lot of systems. A lot of organizations and departments coming together. Susan asks awesome questions, and is patient in the not knowing what she doesn’t know.

The only downside/fear I have in all of this is that she is too much of an examplar. Will people expect every patient and family leader to have the same skillset and background? Not every patient who will design systems with us will. Will some patient and family leaders not work out? Sometimes. We deal with that with our colleagues all the time, though, and there we celebrate the diversity. It will be no different here.

If I envision a health system 10 years from now, yes, there will be more technology, a different generation, sustainable buildings, food and transportation :), all awesome.

I want the health system to think about something that’s not new technology that will have just as much impact, if not more…. listening. When we think about the model of health, it won’t just be about what we do for or to the people we serve, it will be how we do things with the people we serve.

This is what Susan had to say when I asked her if it was okay for me to talk about her role:

Trust me when I say -“I’m loving it!!!” My background includes a music and drama major from UOP with dreams of becoming “discovered”…….however, I did get my teaching credential just in case it took some time…..Well – after doing some stints in summer stock – Starlight, Music Circus, and Melody Land……..I did head into the education arena and really never looked back……..I loved education – However, if I’d known that there was a bit of fame in my future – gosh – I might have had the transplant (that which started all of this) years ago! No – kidding aside……I am thoroughly honored to be part of this vision – the true partnership between Kaiser Permanente and its members (customers)……….I am here today because of Kaiser and so, with that, I’m absolutely here for Kaiser in every way possible……….thanks so much, Susan

I’d say maybe the cross-irony here is that it’s Susan who’s making Kaiser Permanente famous, for showing the world what happens when a health system makes an investment in our members through excellent coordinated medical care, and then supporting our members in investing back for millions of other people who will come after them. 9.5 other million at least 🙂 .

PS Writing this blog post doesn’t mean that “I” did this. That’s never how these things happen. Thanks to a very supportive group of business partners including Melina, the Kaiser Permanente San Diego team, Arlene Pergamit specifically, all of the other members of the group who’ve welcomed Susan as a co-student and teacher, and all of the nurses, doctors, family, and community members who have helped Susan stay healthy so that we may enjoy this innovation in listening.

I love living in the future, don’t you? 


Ted Eytan, MD